Universität zu Köln

Necchi, Andrea, Lo Vullo, Salvatore, Mariani, Luigi, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Watkin, Nick, Ager, Michael, Hakenberg, Oliver W., Heidenreich, Axel, Raggi, Daniele ORCID: 0000-0003-4105-9968, Catanzaro, Mario, Salvioni, Roberto, Chipollini, Juan ORCID: 0000-0003-2603-0382, Azizi, Mounsif and Spiess, Philippe E. (2019). Nomogram-based prediction of overall survival after regional lymph node dissection and the role of perioperative chemotherapy in penile squamous cell carcinoma: A retrospective multicenter study. Urol. Oncol.-Semin. Orig. Investig., 37 (8). NEW YORK: ELSEVIER SCIENCE INC. ISSN 1873-2496

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Abstract

Objectives: To improve the prognostic allocation of patients with penile squamous-cell carcinoma (PSCC) receiving regional lymph node dissection (LND). Patients and methods: An international, multicenter, retrospective study was performed on patients with PSCC who received regional LND, with or without perioperative therapy, from 1980 to 2017. We first used a random forest (RF) method with missing data imputation. Additionally, data were modeled using Cox proportional hazard regression, and a Cox model was also fit including prespecified variables. Based on the latter model, a nomogram for estimating 12-month and 24-month overall survival (OS) was developed. Results: There were 743 patients who received LND at 7 referral centers from Europe, the USA, Brazil, and China. Of these patients, 689 were analyzed: 86 (12.5%) received neoadjuvant chemotherapy (NAC); 171 (24.8%) received adjuvant chemotherapy (AC), and 74 (10.7%) received adjuvant radiotherapy. The variables significantly associated with OS were age (P < 0.001), the pathologically involved/total removed LN ratio (P < 0.001), pN stage (overall P < 0.001), and NAC (P = 0.013). NAC and AC were ineffective in N1-2 patients (clinical and pathological, respectively), whereas they provided OS improvements in N3 patients. Finally, we developed a nomogram predicting 12- and 24-month OS based on prespecified variables (c-index: 0.75). The study is limited by its retrospective nature. Conclusions: We propose a tool that can be offered as an aid to physicians to enhance decision-making, clinical research, and patient counseling whenever LND is needed for PSCC. Administration of NAC and AC should be restricted to clinical and pathological N3 patients, respectively. (C) 2019 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Necchi, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Lo Vullo, Salvatore UNSPECIFIED UNSPECIFIED UNSPECIFIED Mariani, Luigi UNSPECIFIED UNSPECIFIED UNSPECIFIED Zhu, Yao UNSPECIFIED UNSPECIFIED UNSPECIFIED Ye, Ding-Wei UNSPECIFIED UNSPECIFIED UNSPECIFIED Ornellas, Antonio A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Watkin, Nick UNSPECIFIED UNSPECIFIED UNSPECIFIED Ager, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Hakenberg, Oliver W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Raggi, Daniele UNSPECIFIED orcid.org/0000-0003-4105-9968 UNSPECIFIED Catanzaro, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Salvioni, Roberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Chipollini, Juan UNSPECIFIED orcid.org/0000-0003-2603-0382 UNSPECIFIED Azizi, Mounsif UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiess, Philippe E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-133942
DOI:	10.1016/j.urolonc.2019.04.003
Journal or Publication Title:	Urol. Oncol.-Semin. Orig. Investig.
Volume:	37
Number:	8
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1873-2496
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CANCER; NEOADJUVANT; METASTASES; GUIDELINES; ADJUVANT; THERAPY Multiple languages Oncology; Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13394